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Complaint Investigation

Tower Hill Healthcare Center

April 24, 2026 · South Elgin, IL · 759 Kane Street
Citations 1
CMS Rating 1/5
Beds 206
Provider ID 145795
Healthcare Facility
Tower Hill Healthcare Center
South Elgin, IL  ·  View full profile →
Source Document
Official CMS Inspection Report (Medicare.gov)
Downloaded from CMS/Medicare.gov. Reflects what state inspectors documented and does not include the facility's plan of correction, which is submitted separately. Facilities may have taken corrective actions since this report was released.
Inspection Summary

TOWER HILL HEALTHCARE CENTER in SOUTH ELGIN, IL — inspection on April 24, 2026.

Found 1 citation. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

Inspection Findings

FF0689
Quality of Life and Care Deficiencies

prevent accidents.

observation, interview, and record review the facility failed to serve a resident with multiple sclerosis

of 6.The findings include:On 4/24/26 at 10:02 AM, R1 was sitting in his wheelchair in the dining room watching a movie. R1 said he liked the coffee at the facility. R1 said a few days ago he spilled coffee in his lap, but it was all healed up now. R1 said the coffee is not too hot; he likes it just the way it is.

On 4/24/26 at 8:45 AM, V6 Wound Licensed Practical Nurse said R1 was accidently burned when he spilled coffee in his lap. V6 said R1 sustained a second degree burn to his left inner thigh. V6 said R1 was in dining room when it happened, and staff immediately brought him to his room and removed his pants and applied ice to the area. V6 said she was notified and responded to R1's room. V6 said R1's left inner thigh was just red at that time and ice and silver burn cream was applied. V6 said the area did later form two small blisters and has been treated since. V6 said R1's burn is almost healed. R1's Skin/Wound Note dated 4/8/26 shows R1 sustained a second-degree burn.

Upon assessment, writer applied an ice pack to the affected area to help prevent further skin breakdown. On 4/24/26 at 11:12 AM, R1 was sitting in the dining room for the noon meal. R1 was served coffee in a plastic coffee mug with a handle. R1 added powdered creamer to the mug and stirred the coffee. R1, with one hand on the handle of the mug and the other hand on the other side of the mug, drank the coffee. R1's hold on the cup appeared secure and R1's hands were not shaky. On 4/2426 at 12:45 PM, V3 Assistant Director of Nursing said R1 does not need feeding cues or any assistance to eat or drink. V3 said R1 has not had any issues with drinking coffee in the past. V3 said R1 was served coffee that day in a Styrofoam cup, which didn't have any handles. V3 said the facility didn't have enough handled mugs so Styrofoam was being used. V3 said the facility has since ordered more handled mugs and residents will not be served hot beverages in Styrofoam cups. R1's Facesheet shows R1 has diagnoses of multiple sclerosis and dementia.R1's Wound assessment dated [DATE] shows left inner thigh burn, 100% granulation, measure 3.50 x 2.80 x 0.10. R1's Wound assessment dated [DATE] shows left inner thigh, burn, 90% intact skin, 10% pale pink non-granulating, measures 0.8 x 0.5 x 0.10.The facility's Hot Beverage Policy dated 2017 shows Hot beverages are provided to the clients in a safe manner.

Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided.

For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.

LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in SOUTH ELGIN, IL, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from TOWER HILL HEALTHCARE CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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About This Inspection Report

Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.

Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.

Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.